Tuesday, April 16, 2013

Free maternity care means healthier Kenyans

By Lukoye Atwoli

Sunday Nation 14 April 2013

Upon his swearing in last Tuesday, President Uhuru Kenyatta made a promise that should excite all Kenyans, regardless of political persuasion. He promised that within the next one hundred days, his government will eliminate all charges on maternity care in public health facilities. While many are busy examining the financial implications of this promise, and perhaps making conclusions on its feasibility, I would whole-heartedly endorse it as the beginning of better healthcare for all Kenyans.

Indeed, increasing the proportion of deliveries assisted by skilled attendants in hospitals has many benefits. Firstly, the money that would have been spent on deliveries can be put to other use by the family, such a buying food and clothing or paying for education and accommodation.

Secondly, this move will ensure that babies are born in safe environments, reducing the risk of complications and ensuring that they get all requisite immunisations and treatment early in life. Their mothers are also more likely to get educated on better childcare techniques, improving the health of their offspring.

The resulting good health will inoculate children against malnutrition and diseases, and give them a healthy start in life. This will improve their chances of succeeding in academics, sports and any other areas they choose to participate in. The benefits to society would be incalculable when we have a large pool of highly motivated, healthy youth ready to put their ideas into practice.

But there are a few bottlenecks that will threaten the president’s declaration, right from inception. Firstly, all healthcare services at the county level are meant to be under the county governments. The role of the national government in health is limited to supra-county functions such as national referral health facilities, disaster management, and health policy.

Before rolling out the free maternity care services, it will be prudent for the national government to constructively engage the county governments to work out modalities of its implementation. Ad hoc implementation will result in a chaotic situation where counties allied to the national executive do one thing, while others do another. The loser will be the ordinary Kenyan.

Secondly, free health services of any shade require investment in infrastructure, human resources and consumables. In order to implement this promise, the government will have to develop a plan to improve the existing infrastructure, train and recruit a qualified health workforce, and ensure consistent supply of medications and other supplies.

Finally, maternity services cannot be offered in isolation. The incoming government needs to develop a comprehensive health policy that will ensure that all common causes of morbidity and mortality are addressed. One would expect that these plagues would also come under the “free service” ambit, in order to more comprehensively improve the health of Kenyans.

If the government increases health expenditure to at least 15 per cent of the budget as set out in the Abuja Declaration, we shall be able to offer not only free maternity services, but also free child health, mental health and public health interventions. This can be accomplished within the next five years, if the government is prepared to back its promises with political goodwill and financial support.

Hopefully the president will demonstrate this when he addresses Parliament on Tuesday.

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association and a senior lecturer at Moi University’s School of Medicine lukoye@gmail.com; Twitter @LukoyeAtwoli